Eshetu Ejeta Chaka

Background: The rapid spread of the invasive malaria vector Anopheles stephensi in Africa, coupled with increasing reports of insecticide resistance, presents an emerging challenge for malaria vector control. We conducted a systematic review and meta-analysis to compare insecticide resistance profiles and underlying resistance mechanisms between native Asian and invasive African populations and assessed their implications for insecticide resistance management. Methods: PubMed, Google Scholar, Web of Science, WHO IRIS, and gray literature sources were searched using terms related to An. stephensi, insecticide susceptibility, and resistance mechanisms. Data were extracted into Excel, critically appraised using an adapted Joanna Briggs Institute checklist, and analyzed using Comprehensive Meta-analysis software. The protocol was registered in Prospero International Registrar for Systematic Review and Meta-analysis in April 2025 (ID: CRD420251007131). Results: Thirty-one studies published between 2000 and 2025 were included. Pooled mortality was lower in invasive than native populations for the pyrethroids assessed in both ranges, including deltamethrin (72.6% vs. 83.5%), permethrin (68.3% vs. 89.0%), and lambda-cyhalothrin (47.0% vs. 87.0%), as well as for DDT (36.0% vs. 47.7%). Mortality was also lower in invasive populations for bendiocarb and propoxur, although propoxur was assessed in only one native-range study. Between-study heterogeneity varied substantially. Target-site mutations were reported at low frequencies; L1014F ranged from 1.4% to 32.9% in native populations and was detected in one study in invasive-range (5.7%), while L1014S (21.4–35%) was reported only in native-range. Metabolic resistance mechanisms involved cytochrome P450s (CYP4 and CYP6 families), glutathione S-transferases (GSTe2 and GSTe4), and esterases, including esterase E4 and carboxylesterase-6. No acetylcholinesterase-1 (ace-1) mutations were reported. Conclusion: Anopheles stephensi exhibits resistance to multiple insecticide classes across its native and invasive ranges, with lower pooled mortality observed in the invasive range. Available evidence indicates an important contribution of metabolic detoxification, while target-site resistance markers, including vgsc L1014F/L1014S, were detected at lower frequencies and remain poorly characterized in invasive populations. High between-study heterogeneity warrants cautious interpretation and highlights the need for standardized phenotypic and molecular surveillance to guide locally tailored insecticide resistance management as An. stephensi continues to spread in Africa.

Background: Disrespectful care violates women’s rights, delays care-seeking and contributes to preventable adverse birth outcomes. Although Respectful Maternity Care (RMC) is a key strategy for improving maternal and neonatal health, evidence on factors affecting its implementation in least-developed countries remains poorly synthesised. Objective: To assess the barriers and facilitators of RMC in low-income countries. Design: Systematic review synthesising evidence from qualitative and mixed-methods studies was conducted. Data sources and methods: A systematic search was conducted across major databases, including Scopus, Web of Science, PubMed, CINAHL, and Embase. Eligibility criteria were defined using the SPIDER framework. Studies published between 2015 and 2025 were included. Methodological quality was assessed using JBI SUMARI for qualitative studies and the QATSDD tool for mixed-methods studies. SPIDER framework was applied to support eligibility criteria. The review followed PRISMA guidelines. The data were synthesised using thematic analysis and applied to the Socio-Ecological Model. Results: Forty-eight studies conducted in least-developed countries were analysed, consisting of 36 qualitative studies and 12 mixed-methods studies. Barriers and facilitators to RMC were identified at individual (knowledge, attitude, skills), interpersonal, organizational (resources, infrastructures), policy (guidelines, education), and socio-cultural level (norms, cultures). Conclusion: Strengthening RMC is crucial for reducing maternal and neonatal mortality. The review highlights the need for supportive policies, improved infrastructure, and targeted provider training. Future research should develop and validate context-specific RMC principles and indicators to strengthen providers’ understanding and skills for practice in least-developed countries. Registration: The protocol was registered with PROSPERO (CRD42023443998).

Measuring women’s experiences of Respectful Maternity Care (RMC) requires valid and reliable tools. Although several RMC tools exist, their methodolo

Background Birth preparedness and complication readiness (BPCR) are essential components of maternal health that encourage proactive planning and decision-making during pregnancy and childbirth. However, there is limited information available regarding the status of BPCR, particularly in our study area. Therefore, this study aimed to assess birth preparedness, complication readiness and associated factors among pregnant women attending public health facilities in the Chelia District. Methods A facility-based cross-sectional study was conducted among 410 pregnant women at public health facilities, using a systematic random sampling method. Descriptive statistics, such as frequencies, and summary statistics were calculated for the relevant variables. Bivariate and multivariate binary logistic regression analyses were performed to evaluate the relationship between dependent and independent variables. The strength of the association was measured using an OR with a 95% CI. Statistical significance was determined at a p value of 0.05. Results A total of 406 mothers participated in the study, resulting in a 99% response rate. The study found that 245 (60.3%) respondents were well-prepared for birth and complication readiness. Several factors such as: family size (adjusted odds ratios (AOR)=0.18; 95% CI (0.09 to 0.35)), decision-making with husbands (AOR=2.43, 95% CI (1.44 to 3.32)), parity (AOR=0.32; 95% CI (0.16 to 0.62)), lack of awareness about birth preparedness (AOR=0.30; 95% CI (0.16 to 0.57)), not knowing about the existence of a waiting home (AOR=0.31; 95% CI (0.19 to 0.48)) and not participating in a pregnant women’s conference (AOR=0.50; 95% CI (0.32 to 0.79)) were significantly associated with BPCR. Conclusion The study found that the level of BPCR is low in the study area. Family size, decision-making with husbands, awareness of maternity waiting homes, participation in pregnant women’s conferences, knowledge about BPCR and parity were significantly associated with BPCR. Therefore, strengthening pregnant women’s conferences, encouraging husband involvement in decision-making and ensuring maternity waiting homes at health facilities are important.

Background and Aims: Early identification and treatment of hypertension could lower the risk of cardiovascular diseases; which share the largest proportion of death. The findings of previous studies done in Ethiopia on undiagnosed hypertension were inconsistent. Therefore, this systematic review and meta‐analysis aimed to assess the prevalence and associated factors of undiagnosed hypertension among adults in Ethiopia.Methods: A protocol with registration number CRD42023395445 was registered to Prospective Register of Systematic Reviews (PROSPERO). A comprehensive search of observational studies done on undiagnosed hypertension was identified in PubMed, Google Scholar, Cochrane Library, Hinari databases, and other sources available until January 10, 2023. The quality of the identified studies using the set criteria and necessary data was extracted and exported to R version 4.2.3 and STATA version 15.0 for analysis. The pooled prevalence of undiagnosed hypertension and its associated factors were identified. The risk of bias was evaluated using a funnel plot and Egger's test. The findings were presented using tables, figures, and statements. This study was not funded by any organization.Results: Eleven studies having 6132 participants were included in the analysis. The pooled prevalence of undiagnosed hypertension was 21% (95% confidence interval [CI]: 16–27). In subanalysis, according to the American Heart Association ( ≥ 130/80 mmHg), the pooled prevalence was 29% (95% CI: 18–40). However, according to the International Society of Hypertension ( ≥ 140/90), the pooled prevalence was 16% (95% CI: 13–20).Sex (AOR = 2.49, 1.48–3.49), age ≥55 years (AOR = 2.68, 1.16–4.21), alcohol drinking (AOR = 2.68, 1.68–3.69), body mass index ≥25 kg/m² (AOR = 2.62, 1.77–3.48), and high triglyceride levels (AOR = 1.87, 1.22–2.51) were significantly associated with it.Conclusion: In Ethiopia, about one in five adults ≥ 18 years has undiagnosed hypertension; therefore raising public awareness for medical checkups, early hypertension detection, and treatment is suggested. However, these findings cannot be generalized to pediatrics.

Continuum of care (CoC) has been recognized as a crucial strategy for minimizing maternal, neonatal, and child mortality. CoC promotes integrated Maternal Neonatal and Child Health (MNCH) services by linking together three aspects of maternal health care antenatal care, skilled birth attendance, and postnatal care. The study aimed to assess continuation of maternal healthcare services utilization and its associated factors among reproductive age women at pregnancy, delivery and postnatal stages in Ethiopia. Cross-sectional study design conducted using Ethiopian 2016 Demographic and Health Survey data. All women with the most recent live birth in the last five years preceding the 2016 survey were the study population. The sample size was 7590, 2415, and 1342 at service entry (ANC use), COC at a delivery level, and CoC at Postpartum level respectively. COC was measured at three levels of maternal health care (during pregnancy, delivery, and postpartum). The CoC is constructed from four or more antenatal care visits (ANC4+), skilled birth attendance (SBA), and postnatal care (PNC). About 9.1% of women received all components of CoC. Educational attainment, wealth quintile, and media exposure were associated with four or more antenatal care visits and COC at the delivery level. Perception of getting money for healthcare, having blood pressure measured and urine sample taken during ANC was associated with continuity of care at the delivery level and continuity of care at a postpartum level. Birth order, residence, and region were common factors associated with each outcome of interest. The proportion of women who received all ANC4+, SBA, and PNC across the CoC was low in Ethiopia. Effort needed to increase CoC at each stage. The study shows that focusing on place of residence and regional state variation is necessary to improve CoC at each level. Thus, contextualizing the strategies and further research are critical.

Introduction: The pandemic of coronavirus disease-2019 has fundamentally changed the physician–patient relationship due to health care workers’ being at high risk of getting COVID-19 infection from their patients. Therefore, healthcare workers are a priority to be protected and prevent transmission within a healthcare setting. Objective: To assess the actual and perceived personal safety of healthcare workers practicing in public hospitals. Methods and Materials: A descriptive cross-sectional study design was done among 361 health professionals in West Shoa. A simple random sampling technique was used to select representative respondents. Data was collected by a pretested, self-administered questionnaire. The collected data was entered into EPI-Info and exported to STATA for analysis. Descriptive statistics were used to present the data. Results: A total of 361 healthcare workers responded to the question with a 97% response rate. The median age of the study participants was 29. Of the total participants, access to personal protective equipment was: hand sanitizer 322 (89.2%), disposable gloves 285 (78.9%), face mask 280 (77.6%), KN95 face mask 163 (45.2%) and facial protective shields 112 (31%). One hundred sixty-nine (46.8%) of the study participants reported that their hospital has personal safety policies and procedures. One hundred sixty-one (44%) reported that they perceived no support, while only 35 (9.7%) participants reported that they perceived full support from their hospital. Furthermore, the participants perceived that their local concerned bodies took fewer necessary measurements to defend physical integrity in the workplace (mean 2.86 SD = 3.34). Conclusion: There are many healthcare workers who have limited access to the majority of essential PPE. The majority of study participants perceived limited support from their health facilities, hospitals and local concerned bodies. Therefore, hospitals and local public health authorities should increase access to PPE to protect healthcare workers.

Purpose: To assess the non-prescription use of antibiotics and associated factors in Ambo Town, West Shoa, Oromia, Ethiopia. Methods: An institutional-based cross-sectional study design supported with the qualitative study was conducted in Ambo Town from February 1 to March 1, 2020. Data were collected using a pretested semi-structured questionnaire and in-depth interview guide questions. Simple random sampling was used to select retail outlets and systematic random sampling to select study participants. The data analysis was done using SPSS and univariate and multivariate binary logistic regression analysis was performed to identify factors associated with non-prescription use of antibiotics. Thematic framework analysis was applied for the qualitative data. Results: From the 421 study sample, a total of 399 participants were interviewed with a 94.8% response rate. Among the study participants, 214 (53.6) were males, 228 (57.1%) were married, 191 (47.9%) were orthodox by religion, and 343 (86%) were Oromo by ethnicity. One hundred seventy-two (43.1%; 95% CI: 38.6, 48.1) of the participants had used non-prescribed antibiotics. Being male [AOR=2.21 95% CI: 1.276, 3.835], residing in rural area [AOR=3.659, 95% CI: 1.479, 9.054], holding diploma [AOR=0.120, 95% CI: 0.025, 0.591], and hold BSC degree [AOR=0.050, 95% CI: 0.007, 0.378], and being farmer [AOR=0.034, 95% CI: 0.004, 0.285] showed significant association with the non-prescription use of antibiotics. Conclusion: This study concluded that the non-prescription use of antibiotics 172 (43.1%) was relatively high. Being male, residing in a rural area, holding a diploma, BSc degree, and being a farmer were significantly associated with non-prescription use of antibiotics. So, West Shoa Zone regulatory body should actively focus on the prevention of non-prescription use of antibiotics through health communication and public awareness on the demerits of non-prescription use of antibiotics.

Background The non-prescription use of antibiotics is a major challenge faced by all nations. The practice is pronounced in developing and low-income countries where legislation and regulations are weak. The present study assessed the non-prescription use of antibiotics and associated factors in Ambo town, West Shoa, Oromiya, Ethiopia. Methods Institutional based cross-sectional study design supported with the qualitative study was conducted in Ambo town from February 1to March 1, 2020. Data were collected using a pre-tested semi-structured questionnaire and in-depth interview guide questions. Simple random sampling was used to select retail outlets and systematic random sampling to select study participants. The data analysis was done using SPSS and univariate and multivariate binary logistic regression analysis were performed to identify factors associated with non-prescription use of antibiotics. Thematic framework analysis was applied for the qualitative data. Results From a 421 study sample, a total of 399 participants were interviewed with a 94.8% response rate. Among the study participants 214 (53.6) were males, 228 (57.1%) were married, 191(47.9%) were orthodox by religion and, 343(86%) were Oromo by ethnicity. One hundred seventy two (43.1%) 95% CI= (38.6, 48.1) of the participants had used non prescribed Antibiotics. Being male [AOR = 2.21 95%CI 1.276,3.835], residing in rural area [AOR = 3.659, 95%CI 1.479, 9.054], holding Diploma[AOR = 0.120, 95% CI 0.025, 0.591], and hold BSC Degree [AOR = 0.050, 95% CI 0.007, 0.378], and being farmer [AOR = 0.034, 95% CI 0.004, 0.285] showed significant association with the non prescription use of Antibiotics. Conclusion This study concluded that the non-prescription use of antibiotics 172 (43.1%) was relatively high. Being male, residing in a rural area, holding a diploma, BSc Degree, and being a farmer were significantly associated with non-prescription use of antibiotics. So West Shoa Zone regulatory body should actively focus on the prevention of non-prescription use of Antibiotics through health communication and public awareness on the demerits of non-prescription use of Antibiotics